title: Crimean-Congo hemorrhagic fever: seroprevalence and risk factors among humans in Achaia, western Greece.
abstract: BACKGROUND
  The Crimean-Congo hemorrhagic fever virus (CCHFV) presents a wide distribution, with the Balkan Peninsula being among the endemic regions. To date, only one CCHF case has been reported in Greece; however, based on seroprevalence data, there is evidence that CCHFV circulates in the country. Achaia is a prefecture in western Greece that has not previously been studied for CCHFV.
  
  
  OBJECTIVE
  The aim of this study was to estimate the seroprevalence of CCHFV in humans in Achaia Prefecture, Greece, and to assess possible factors playing a role in seropositivity.
  
  
  METHODS
  A total of 207 serum samples from people of all age groups, from both urban and rural areas, were prospectively collected and tested for IgG antibodies against CCHFV.
  
  
  RESULTS
  The overall seroprevalence was 3.4%, with significant differences among municipalities. An agro-pastoral occupation, contact with sheep and goats, former tick bite, increasing age, and living at an altitude of ≥400 m, on specific land cover types, were significantly associated with CCHFV seropositivity.
  
  
  CONCLUSIONS
  A relatively high seroprevalence was detected in a previously unstudied region of Greece, where CCHFV infection seems to occur mainly through tick bites. Further investigations are needed to identify the circulating CCHFV strains in Greece, in order to gain a better understanding of CCHFV ecology and epidemiology in the country.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Patras University General Hospital, Patras, Greece; Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, 54006, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Sargianou
authors.forename: George
authors.initials: G
authors.lastname: Panos
authors.forename: Andreas
authors.initials: A
authors.lastname: Tsatsaris
authors.forename: Charalambos
authors.initials: C
authors.lastname: Gogos
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D062306:Geography, Medical; D006115:Greece / Q000453:epidemiology; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000276:immunology* / Q000302:isolation & purification; D006479:Hemorrhagic Fever, Crimean / Q000453:epidemiology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D016036:Seroepidemiologic Studies
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G
keywords: Crimean-Congo hemorrhagic fever; Epidemiology; Greece; Risk factors; Seroprevalence